Bayesian evidence for the neural dissociation between finger and hand imitation skills

Abstract

Introduction: For limb apraxia ‒ a heterogeneous disorder of higher motor cognition following stroke ‒ an enduring debate has arisen regarding the existence of dissociating neural correlates for finger and hand gestures in the left hemisphere. We re-assessed this question asking whether previous attempts analysing pooled samples of patients with deficits in only one and patients with deficits in both imitation types might have led to systematically biased results. Methods: We conducted frequentist and Bayesian, voxelwise and regionwise lesion symptom mappings on a pooled sample (N=96) and subsamples containing only shared and only isolated hand and finger imitation deficits and respective controls. Results: Anatomical analyses on the isolated sample reinforced a cortical dissociation of finger deficits (located more anteriorly) and hand deficits (located more posteriorly). The presence of patients with shared deficits did indeed dilute associations that appeared stronger in the respective isolated samples. Also, brain regions truly associated with hand imitation deficits showed a positive bias for finger imitation deficits, when the sample contained patients with shared deficits. In addition, our frequentist parameters uncovered that some of our Bayesian evidence supported reverse associations (damage protecting from rather than increasing the deficit). Discussion: Joint analyses of patients with shared and isolated imitation deficits do indeed lead to biases, which may explain why some previous studies have failed to detect the actual neural dissociation between hand and finger imitation deficits.